| NPI | 1790983203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: FL ME99288) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME99288) |
| 207RG0300X Internal Medicine Geriatric Medicine (Licence: FL ME 99288) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2013-10-18 |